1477723450 NPI number — PRESIDENT & FELLOWS OF HARVARD COLLEGE

Table of content: MR. ROBERT FRANCIS BARRY JR. LAC DIPL OF AC (NPI 1740349141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477723450 NPI number — PRESIDENT & FELLOWS OF HARVARD COLLEGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESIDENT & FELLOWS OF HARVARD COLLEGE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HARVARD UNIVERSITY HEALTH SERVICE OPTOMETRY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477723450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 MOUNT AUBURN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02138-4960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-496-9506
Provider Business Mailing Address Fax Number:
617-495-6059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 MOUNT AUBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02138-4960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-496-9506
Provider Business Practice Location Address Fax Number:
617-495-6059
Provider Enumeration Date:
03/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
COLE
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR REVENUE CYCLE MGMT
Authorized Official Telephone Number:
617-496-9506

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: W20447 . This is a "BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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